BP13410Blair Building Permit-Detail'
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Permit #: 13410 Issued: 4/5/2010 Type: Decks - All types
Completed: 4/22/2010 Valuation: 4050
Location: 1508 Oak Dr
Owner: Mitch Jones (Holding 50.00 deposit) Permit Fee: 96
Address: 1508 Oak Dr Issue Fee: 25
Deposit Amt.: 50
Blair, NE 68008 Receipt #: 26483
Phone: 402 426 5779
Section: Township: Range:
Subdivision: Lot: 10 Block:
9x18 deck off rear of house 7' off of ground. Holding a 50.00 deposit.
Contractors
Gordy Ray Construction General Contractor Permit # Issued
Remarks
4/7/2010 BMP Holding a 50.00 deposit until 7/7/2010
Inspections Date By
4/9/2010 HOW Footings Pass
4/22/2010 HOW Final Inspection of Project Pass
Site Plan Attached:
PLIOTDING PERMIT
Approximate Completion Date: sb //(-)
REScheck Attached: Complete Plans Attached
Application for: Residential Commercial/Industrial
New Construction Manufactured Home Modular
Move -on: Home Accessory Building Other
Remodel Addition
Accessory Building: Garage Pole Barn Other
Floor Type: Dirt Concrete Electricity: Yes o
Sign Erecting, Awnings Decks/Handicap Ramps (plot pian required)
Satellite Dishes/Radio Antenna/Cell Towers (plot plan required)
Other
Utilities: Public Water: Yes No Private Well
If yes, responsible entity: Blair OPPD Line Kennard
Agreement needed: Date Agreement Received:
Public Sewer: Yes No Septic Drawing Provided:
If yes, responsible entity: Blair Kennard
County Road Permit Required: Yes No Submitted: Yes No
Description of project if n cessary: i<
Project Information:
r
Job Address:
Legal Description (if applicable)
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Owner: K -3 C) tCNes Address:
Contractor:
Address:
2.9 23 'pct ,� cu- La -At
Phone#:
Phone #:LLS
Cell #: ES3-06GE
Email Address for Contractor: Cel f a A =(�`�t -11 � CJhocl , corf\
Separate permits are required for electrical, plumbing, hearting, ventilating and air conditioning, and septic systems. By my signature
below, I acknowledge this building permit application does not constitute issuance of this building permit. I further agree that
construction covered by this permit application shall not be commenced until I have received a copy of a permit signed by the Building
Inspector. I hereby agree to perform the proposed work in accordance with the specifications set forth above and in accordance with the
codes/ordinances of the City of Blair and the State of Nebraska. I understand that this permit is void if work is not commenced within
1180 days is not completed
�within
�two (2) years of date of issue.
gnature of Owner/Contrtor Date
For Building Permits other than One & Two Family Residential Structures:
I hereby acknowledge and agree that I have/will submit a set of plans for this project to the Nebraska State Fire Marshal's Office for
Review.
Signature of Owner/Contractor
Date
ZONING REVIEW:
Zoning/Flood Plain/Utilities:
Current Zoning: V.Conditional Use Permit Required: Yes No ,-
Date CUP Approved:
State Fire Marshal Required: Yes No Variance Required: Yes No
Minimum Setbacks: Front Second Front Side Side -4__Rear '
Lot Sauare Footage:
Length x Width: Lot Coverage %
Driveways/Sidewalks:
Sidewalk required: Yes No Sidewalk Waiver: Yes No
Date Waiver Approved:
Preexisting Garage requires driveway to be less than 3' from property line: Yes
Approved by:
Flood Plain: Yes No
If yes, specify special requirements:
BUILDING INSPECTOR REVIEW:
Number of Stories
One Two Three Four
Type of Residential Structure:
Ranch Two Story Split Entry _
Rooms Bedrooms Bathrooms
>Four High Rise (>75 ft)
Raised Ranch Other
Fireplaces Gas Electric
Egress in Basement: Required: Yes No Provided on Plans: Yes
Sleeping Rooms Living Area Other Egress
Sauare Footage:
M
Main Level: Second Level: Third Level
Basement: (Unfinished) (Finished)
Garage: 2 bay 3 bay 4 bay 5+ bay
Detached Garage: Pole Barn:
Addition: Remodel:
Porch: Front Rear Side
Deck that affect setbacks: Rear Front Side
Occunancv Classification:
Assembly, theaters, with stage Assembly, theater, without stage
Assembly, nightclubs Assembly, restaurants, bars, banquet halls
Assembly, churches Assembly, arenas
Assembly, general, community halls, libraries, museums
Business Educational Factory and industrial, moderate hazard
Factory and industrial, low hazard High Hazard, explosives
(section continued on next page)
AAML. - 1YCVV %julValnuk,IIVINI 1AUU1IIVIV01 r(CIVIVUCLJ:
Business/Industrial/Educational/Assembly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Construction valuation computation: Sq/ft area X $63
Except for the following:
Accessory Buildings & Interior Remodeling Projects: sq/ft area X $43
Pole barns with no hard surfac loor: sq/ft area X $25
Sign Erecting/Awnings a ck-,,AHandicapamps: sq/ft area X $25 (Minimum
valuation of $2000)
Construction valuation computation:
Finished sq/ft area X $ Z5 $ 050 °U
Construction valuation is ...................................Permit
fee is:
$0 TO$50...........................................................$0
$51 TO $500 ........................................................
$25
$501 TO $2,000........................................................$25
+ $3
per additional $100
$2,001 TO $25,000........................................................$70
+ $13
per additional $1,000
$25,001 TO $50,000......................................................$370
+ $10
per additional $1,000
$50,001 TO $100,000......................................................$620
+ $7
per additional $1,000
$100,001 TO $500,000......................................................$970
+ $5
per additional $1,000
$500,001 TO$1,000,000..................................................
$2,970
+ $4
per additional $1,000
$1,000,001 AND OVER..................................................$4,970
+ $3
per additional $1,000
Permit Fee calculated from chart above
$ LO •®O
Issuance Fee:
$ 25.00 /2
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
$
Additional Comments:
Approved b : .��7,��
pp y
Date: i
Contingent On Approval by Fire Marshall
Meet IBC, IPC, IMC and NEC Code Requirements
Sleeping Rooms below Story and in Basement required to have egress
For Office Use Only
Date Permit Paid:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to.
Building Inspection Pouch given: Yes No
High Hazard HPM Institutional, supervised environment
Institutional, incapacitated Institutional, restrained
Institutional, day care facilities Mercantile Residential, hotels
Residential, multiple family Residential, one- and two-family
Residential, care/assisted living facilities
Storage, moderate hazard Storage, low hazard Utility, miscellaneous _
Is building required to be protected by automatic fire sprinkler system?"
No
Only partially in some areas or rooms Please Specify
Yes If yes, the standard to which the sprinkler system will be designed:
NFPA 13 NFPS 13R NFPA 13D
Driveway Grade: 20% grade or less? Yes No
(Dale will review new residential construction. Al will review all second access requests and industrial and
commercial driveway requests)
Required Off Street Parking:
Permit Fee Calculation:
Building Permit Deposit Fee:
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $
Fee - $500.00
Residential -add itions%remodels/accessory buildings valued under $10,000 $
Fee = $200.00
All other permits Fee = $50.00 $
RESIDENTIAL - NEW CONSTRUCTION:
Permit fee is:
Finished sq/ft area X $92
$
(not including finished basement area)
Finished basement sq/ft area X$56
$
Unfinished basement sq/ft area X $29
$
Garage sq/ft area X $25
$
Total Valuation:
$
Total Valuation Multiplied by 0.006 =
$
Issuance Fee:
$ 25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
$
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
ADDRESS
CITY, STATE, ZIP CODE
THANK YOU KEEPTHIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair. NE 68008
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�Promisa°Pae
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # 1 Sy
Date: 41 S Approximate Completion Date: S
b //(-)
Site Plan Attached: REScheck Attached: Complete Plans Attached
Application for: Residential Commercial/Industrial
New Construction Manufactured Home Modular
Move -on: Home Accessory Building Other
Remodel Addition
Accessory Building: Garage Pole Barn Other
Floor Type: Dirt Concrete Electricity: Yes o
Sign Erecting, Awnings Decks/Handicap Ramps (plot pian required)
Satellite Dishes/Radio Antenna/Cell Towers (p►otpian required)
Other
Utilities: Public Water: Yes No Private Well
If yes, responsible entity: Blair OPPD Line Kennard
Agreement needed: Date Agreement Received:
Public Sewer: Yes No Septic Drawing Provided:
If yes, responsible entity: Blair Kennard
Cdunty Road Permit Required: Yes No Submitted: Yes No
Description of project if necessary: q X 1 � ecX_ C EfCkr
,\6use - -I ' 0-4 01(0utrn
Project Information:
�0 g d K J� ► ��
Job Address: � Co C��
Legal. Description (if applicable) Lat I �} �� �$ 0►1 5 }�dCt ( 01 1
II
Owner: I (C% 3-C) f\eS Address:
Contractor:
Phone#:
Phone #LLO 0 lir:�7_7 �
Address: 29 23 k-l(A L� �e- Cell #:
Email Address for Contractor: 0 (a(A = c �� {1 l � L (A a_ 1rbo . Cam
Separate permits are required for electrical, plumbing, hearting, ventilating and air conditioning, and septic systems. By my signature
below, I acknowledge this building permit application does not constitute issuance of this building permit. I further agree that
construction covered by this permit application shall not be commenced until I have received a copy of a permit signed by the Building
Inspector. I hereby agree to perform the proposed work in accordance with the specifications set forth above and in accordance with the
codes/ordinances of the City of Blair and the State of Nebraska. I understand that this permit is void if work is not commenced within
180 daysf is not completed
%within two (2) years of date of issue.
gnature of Owner/Controttor Date
For Building Permits other than One & Two Family Residential Structures:
I hereby acknowledge and agree that I have/will submit a set of plans for this project to the Nebraska State Fire Marshal's Office for
Review.
Signature of Owner/Contractor
Date
Wit
ISI
NI unit -
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000.
(A$50.00 fundable deposit is being collected for all misc. permits.
IThe_ City reserves the right to not refund this deposit if any of the following
conditions occur during the construction period:
1) Theft of water service by the plumber, owner or general contractor.
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection.
5) The project is completed without a final inspection being done.
6) Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
hereby agree to the above conditions, and understand that should any or
all of the above situations occur, the building permit deposit SHALL be forfeited or
discounted upon the discretion of the City of Blair, Building and Inspections
Department.
Contractor/Owner
Date
Contractor/Owner
City of Blair
0 CITY OF BLAIR
LOCATION OF INSPECTION:.
NAME OF
REPORTBUILDING INSPECTION
❑ WASHINGTON COUNTY ❑
DATE INSPECTION REQUESTED _ TIME INSPECTION REQUESTED '' ° •PERMIT NO
TYPE OF INSPECTION REQUESTED ❑ CONFERENCE
❑ STATUS CHECK
7-
BUILDING: "Q7
--'FOOTING
FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL [:1 FINAL El PARTIAL
PASSED
FAILED
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC L❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
F]
PARTIAL
❑
F1COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
❑
PARTIAL
F]
❑
COMMENTS:
MECHANICAL: ❑
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
F]
PRESSURE TEST
El
ElCOMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
INSPECTOR: DATE OF INSPECTION MADE: vr7- � Tm / C_ j 0
FAXED OPPD\BURT REA TO CONNECT SERVICE:
YV.
CITY OF BLAIR
LOCATION OF INSPECTION:
NAME OF OWNER•
❑ WASHINGTON COUNTY ❑ OTHER
I s�r
DATE INSPECTION REQUESTED• P L . x" TIME INSPECTION REQUESTED-
Yll
PERMIT NO:
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑, FINAL ❑ PARTIAL
PASSED
FAILED
COMMENTS:
9 -- �2 r� n �� S
❑
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
MECHANICAL: ❑
ROUGH IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
❑
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
INSPECTORI DATE OF INSPECTION MADE: `_ 0 TIME- a 3,
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON - BY
��_-
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